What is Sudden Death Syndrome?
Sudden unexpected death syndrome, Sudden unexpected nocturnal death syndrome (SUNDS), Sudden Unknown Death Syndrome, or Sudden Adult Death Syndrome is sudden unexpected death of adolescents and adults, many during sleep. Sudden unexplained death syndrome was first noted in 1977 among Hmong refugees in the US. The disease was again noted in Singapore, when a retrospective survey of records showed that 230 otherwise healthy Thai men died suddenly of unexplained causes between 1982 and 1990: In the Philippines, where it is referred to in the vernacular as bangungot, SUNDS affects 43 per 100,000 per year among young Filipinos. Most of the victims are young males.
SUNDS has been cloaked in superstition. Many Filipinos believe ingesting high levels of carbohydrates just before sleeping causes bangungot. It has only been recently that the scientific world has begun to understand this syndrome. Victims of bangungot have not been found to have any organic heart diseases or structural heart problems. However, cardiac activity during SUNDS episodes indicates irregular heart rhythms and ventricular fibrillation. The victim survives this episode if the heart’s rhythm goes back to normal. Older Filipinos recommend wiggling the big toe of people experiencing this to encourage their heart to snap back to normal.
In the Philippines, most cases of “bangungot” have been linked with acute hemorrhagic pancreatitis by Filipino medical personnel although the effect might have been due to changes in the pancreas during post-mortem autolysis. In Thailand and Laos, bangungot (or in their term, sudden adult death syndrome) is caused by the Brugada syndrome.
The condition appears to affect primarily young Hmong men from Laos (median age 33) and northeastern Thailand (where the population are mainly of Laotian descent)
Sudden infant death syndrome
Sudden infant death syndrome (SIDS), also known as cot death or crib death, is the sudden unexplained death of a child less than one year of age. It requires that the death remains unexplained even after a thorough autopsy and detailed death scene investigation. SIDS usually occurs during sleep. Typically death occurs between the hours of 00:00 and 09:00. There is usually no evidence of struggle and no noise produced.
The exact cause of SIDS is unknown. The requirement of a combination of factors including a specific underlying susceptibility, a specific time in development, and an environmental stressor has been proposed. These environmental stressors may include sleeping on the stomach or side, overheating, and exposure to cigarette smoke. Accidental suffocation such as during bed sharingmay also play a role. Another risk factor is being born before 39 weeks of gestation. SIDS make up about 80% of sudden and unexpected infant deaths (SUIDs), with other causes include infections, genetic disorders, and heart problems. While child abuse in the form of intentional suffocation may be misdiagnosed as SIDS this is believed to make up less than 5% of cases.
The most effective method of preventing SIDS is putting a child less than one year on its back to sleep. Other measures include a firm mattress separate from but close to caregivers, no loose bedding, a relatively cool sleeping environment, using a pacifier, and avoiding exposure to tobacco smoke. Breastfeeding and immunization may also be preventative. Measures not shown to be useful include positioning devices, baby monitors and fans. Grief support for families impacted by SIDS is important as the death of the infant is sudden, without witnesses, and often associated with an investigation.
Rates of SIDS vary nearly tenfold in developed countries from one in a thousand to one in ten thousand. Globally it resulted in about 15,000 deaths in 2013 down from 22,000 deaths in 1990. SIDS was the third leading cause of death in children less than one year old in the United States in 2011. It is the most common cause of death between one month and one year of age. About 90% of cases happen before six months of age, with it being most frequent between two month and four months of age. It occurs more often in males than females.